Laparoscopic repair of recurrent inguinal hernia via a contralateral high-peritoneal-incision approach: a case report

Recurrent inguinal hernias remain surgically challenging, especially after anterior mesh repair, due to dense adhesions and altered anatomy. Laparoscopic transabdominal preperitoneal (TAPP) repair offers diagnostic and therapeutic advantages, but severe adhesions may limit ipsilateral dissection. We report a 77-year-old man with bilateral inguinal hernias, including a recurrent left hernia after mesh plug repair. Anticipating adhesions, a high peritoneal incision was made on the contralateral side, and dissection was extended across the midline. This approach allowed safe identification and repair of the recurrent defect using a ProGrip™ mesh. Although the overlap was limited, additional fixation ensured stability. The patient had an uneventful postoperative course. The contralateral high-incision TAPP approach may represent a feasible and effective option when ipsilateral access is hazardous, highlighting the importance of flexible strategies for mesh placement and fixation in complex recurrent hernias.

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Publication Details

Journal
Journal of Surgical Case Reports
Published
2025-11-01
DOI
https://doi.org/10.1093/jscr/rjaf912
Primary Topic
Hernia repair and management
Type
article
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article

Laparoscopic repair of recurrent inguinal hernia via a contralateral high-peritoneal-incision approach: a case report

Makoto Takahashi, Hisashi Ro, Shun Ishiyama, Kiichi Sugimoto
Journal of Surgical Case Reports
Hernia repair and management
article

Laparoscopic repair of recurrent inguinal hernia via a contralateral high-peritoneal-incision approach: a case report

Makoto Takahashi, Hisashi Ro, Shun Ishiyama, Kiichi Sugimoto
article en

Abstract

Recurrent inguinal hernias remain surgically challenging, especially after anterior mesh repair, due to dense adhesions and altered anatomy. Laparoscopic transabdominal preperitoneal (TAPP) repair offers diagnostic and therapeutic advantages, but severe adhesions may limit ipsilateral dissection. We report a 77-year-old man with bilateral inguinal hernias, including a recurrent left hernia after mesh plug repair. Anticipating adhesions, a high peritoneal incision was made on the contralateral side, and dissection was extended across the midline. This approach allowed safe identification and repair of the recurrent defect using a ProGrip™ mesh. Although the overlap was limited, additional fixation ensured stability. The patient had an uneventful postoperative course. The contralateral high-incision TAPP approach may represent a feasible and effective option when ipsilateral access is hazardous, highlighting the importance of flexible strategies for mesh placement and fixation in complex recurrent hernias.

Journal of Surgical Case ReportsVol. 2025(11)
Juntendo University (JP)
Openalex Percentile: Top 47%
Hernia repair and management
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